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* 1. First Name

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* 2. Last Name

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* 3. Organization

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* 4. At what level(s) does your organization work? (check all that apply)

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* 5. What type of organization do you represent? (check all that apply)

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* 6. What is your working experience navigating issues related to consent to collect or use information about youth? (check all that apply)

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* 7. What barriers prevent you from entering data about minors into a data system for analysis? (check all that apply)

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* 8. How often do you encounter these barriers? (select one)

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* 9. How do these barriers impact (or not) the goals of your work/project/agency?

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* 10. How many people from your organization would be interested in attending the Youth Privacy Summit?

Note: This will be a half day summit including educational information, a panel discussion with experts and federal representatives, and opportunity to ask questions and provide feedback. Ultimately, we hope to build a first round of concrete policy and practice recommendations by the end.

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* 11. What specific barriers and solutions are of interest to you?

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* 12. Are there approaches in your community that are successfully overcoming this particular barrier?

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